Background and aims: The aim of part VII was to both identify international electronically-implemented initiatives, and analyse the feasibility of an electronic parent-child initiative (EKVI) as an application of the Austrian electronic health record (ELGA).

Methods: Identification of international electronic EKVIs by literature search and analysis of the Austrian mother-child pass (ÖMKP) as a paper-based EKVI and information/communication system, based on the needs and requirements of the end users and administrators involved, as well as on current application scenarios within the frame conditions of the ÖELGA.

Results: We identified 30 international projects. Nearly all (paper-based or electronic) EKVIs follow four objectives: health care provision, administration of health care provision, quality through equal access and structured health care provision, processing of benefit payments. Beyond that, electronic EKVIs facilitate the conduct of evaluations, health services research and planning, and provide decision-making support for appropriate levels of care. In practice, the path from local (surgery or hospital) systems to integrated, contact-point spanning health records or ELGA for maternity and infancy still appears not to be fully developed everywhere. Several core aspects could be identified from the first reports as best practice recommendations for a successful planning and implementation of eEKVIs: The definition of expected benefit goals and monitoring the achievement of their targets, the formation of a team responsible for planning and conception -with an early involvement of representatives of both end users and administrators- as well as the consideration of existing work processes and practice patterns. The analysis of actual application scenarios within the current Mother-Child-Pass showed that -under the precondition of a functioning framework structure of ÖELGA, a secured legal basis and a consensus (resp. a legal obligation) between all parties involved to participate- the implementation within ÖELGA is technically feasible.

Conclusion: Any substantive reorientation of an ÖMKP should initially be discussed irrespective of the type of personal health record (electronic or paper-based). Once a broad consensus on new objectives (e.g. the provision of universal vs. risk-group specific health care services) is reached, the development of a suitable form of implementation would be negotiated in the next stage. The implementation of an Austrian eMKP should be planned in realistic time frames, field-tested in the form of regional pilot projects involving the users, and developed with sufficient room for subsequent optimisations.